4661 Cambridge DrCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4661 Cambridge Dr
Lot: 20 Block: 4 Addition: Beacon Hill
PID:10- 13500- 200 -04
Use:
Description:
Sub Type: e- Reroof
Work Type: Replace
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspec
acceptable in lieu of inspections.
Fee Summary:
Valuation: 3,000.00
Contractor:
Signature Home Services
758 Reaney Ave.
St. Paul MN 55106
(651) 731 -1147
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total:
Applicant/Permitee: Signature
- Applicant -
Construction Type:
Occupancy:
Permit Type:
Permit Number:
Date Issued:
Permit Category:
on prior to final, you must meet inspector with ladder and flat bar. Pictures are not
Owner:
Donald Schlafer
4661 Cambridge Dr
Eagan MN 55122
$88.50 0801.4085
$1.50 9001.2195
$90.00
Issued By: Signature
Building
EA085141
08/08/2008
ePermit
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
' GITY OF EAGAN
w 3830 Pilot Knab Road
Eagan, Minnesota 55123
(612) 681-4675
' SITE ADDRESS:
SUBT1tPE:
,li. l 0
Ei i; 1, d T (: k'
)N RECORDPERMIT TYPE:
Permit Number:
Date Issued:
43fr0 J:.'
APPLICANT:
r?;) rrA I I ?
TYPE QF WORK:
10 ','A W; r00 ;>+t=A? 3.r1 { t I:°,
? i
I. ('!
;yr r
Permit No. Permit Holder oate Telephone #
S!W
PLUNIBING
HVAC
ELECTRIC
ELEGTRIC
Inspection Date Insp. Camments
Footings I
Foundaiion
Framing
bc,
Raafing
Rough Plbg.
Rough Htg.
Isul. ?
?
Fireplace
Final Htg.
4rsat Test
Final Pibg_ Plbg. Inspector-Notity Plumber
Canst. Meter
Engr./Plan
Bldg. Flnal //w
ck F g.
Deck Final ?
zv)
?? T? ?p fL
Well
Pr_ Disp. ? ?O ??
EAGAN WATER SERVICE PERMIT
Pil
K
S
b R
i , i
_
ot
no
oad PERMIT NO.:
, Eagan, MN 55142 DATE:
2onin i T ' '
9-
No, of Units: ?
Owner
Address:
SiLe AddresSt??iJ ?. ?. 2{?' $?i ?.?f?£4CUT1 ?.i j,?, lb
Plumber.
Meter No.: Connection Charge:
Size: ACOOUnt Depasit:
Reader No.: Permit Fee:
•I agree to compfr wilh the City of fagon Surcharge:
Ordinonoes. Misc. Chorges: - -
TotaL•
BY Date Pcid: ?
Dote of Insp.: ?nsp
; ?
,
: oF EaGaN
? SEWER SERVICE PERMIT
:
3795
il
K
b
a!
P
no
Road PERMIT NO.:
Eagan, MN 55132 DATE:
Zoning: - - No. of Units:
Owner.
Address;
Site Address: ' CAIL'-L? i' Dx'i. ve,
Plumler:
I agree to eomply with the Cily of Eagan Connection Charge:
Ordinonees. Account Deposit:
Permit Fee:
Surcharge: -
BY Misc. Chorges:
Date of (nsp.: Totol:
Insp.: Date Paid:
CITY OF EAGAN Remarks
Addition BEACON HILL ADDITION Lot 20 gik 4 Parcel 10 13500 200 04
Owner LN?jQS ?. ? I?riik?hStreet 4661 Cambridge Drive state Eagan, MI+1 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. ' 1982 1848.67 205.41 9 1848.57 C007288- 10-2-81
STREET RESTOR.
GRADING ? 1982 537.84 59.76 9 537.84 C007288 10-2-81
SAN SEW TRUNK 1976 135.97 ' 9.06 15 81.61 A010666 -1 -8
*SEWERLATERAL (?4f 198 3182.83 . 353.65 9 3182.83 C007288 10-2-81
WATERMAIN
*WATERLATERAL 1982 9
WATER AfiEA 1982 202.00 22.44 9 202,00 C007288 10-2-81
* Stubs 1982 9
STQRMSEW TRK ^gZ, 1982 267.77 40.86 9 267.77 C007288 10-2-81
*STORM SEW LAT 1982 9
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
? BUILDING PER.
sAC 1981 5 26707 9-10-81
PARK
3795
?
BUILDING PERhAIT
ts " ?e fsr .
Site Address
Lot
Porcei # -
;ITY pF EAGAN
:nob Road Eogon, MN 55122
PHQNEs 454-$100
$59,(]f10
Name C?,;,_'iE?1
Address
I hereby acknowledge that I have rend this opplication ond stote that
the informotion is correct and ogree to comply with all applicoble
State of Minnesota.5totutes and City of Engon Ordinonces.
Slynature of Permittee
!h Building Permlt Is issued to:
all work sholl be done in aCaordonce with oll appliwhle State of Mii
N? 6t?G8
#
,-.f:..-?c•?„ , ,...? . .
Erect 'Q. qccupancy
Rlfer
[]
Zoning
Repoir ? Fire Zone
Enlarge ? Type of Const.
Move p # Stories
Demolish Q Length '
6rade ? Depth ` SQ. Ft.
Assessment
Water & $ew.
Police
Fire
Eng.
Plonner
Council
Bidg. Off.
APC
Percnir -
Surcharge _
Plan chack
SAC
Woter Conr
Water Mete
Road Unit.
Totol
an the express conditlon thal
y of Eagctn Qrdinances.
Buildir?g Official
Permit No. Permit Hoider MisC. Permit No. Holder
Plumbing
r-2q-/
?Sf
H.V.A.C.
Well
YVater
Disp.
Sewer
Electric 7V015l iFi, Tko o ?L?'? -$f
Inspectian pate Insp. Other
Footings
Foundation
Framing
Rough Plbg.
.
Rough HVAC
Insulatian
Final Pibg.
Final HVAC
Final _ ?. ?.,E???_
W?? O?escribe Lacatian:
Weli
Sewer
Pr. pisp.
a?•-
.
.Receipt PLUMBING PERMIT Permit No. _ --
CIfiY OF EAGAN
Fes
Fill in numbered spaces S/C
Type or Print legibly
Tat. ?
1. Date rc,??!r- ??: 7r ?' 2. Installation Cost'.? f
,? .
3. Job Address ; Lot 13 "Tract - g
?
_ i
4. Owner j/d ,r
5. Cdntractord-b+?.; Phone
6. Address
r
7. CitY -?- sf - State Zip
8. Building Type: Residential CI Commercial ? Institutinnal ? ?
;
3
9. Work Description: New ZI Add O Alter ? Repair ? ?
Descri be
I
1
No,
>^, Fixtures
Water Closet No. Fixtures
Cesspaol/Drainfield
1 Bath tubs Se
tic'fank
Lavatory p
Softner
5hower Well
?
- '- Kitchen Sink
Urinal/Bidet
Other
?
Laundry Tray ,_
; . ? .,
} Floor Drains
Drinking Ftn. _
' Slop Sink
Gas Piping dutlets
12. I hereby certify that the above informatian is true and correct, and I agree to
comply with all ardinances and codes governing this type of work.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approued.
Approved CITY QF EAGAN 454-8100
Receip: MECHANICAL PERMIT Permit No. CITY 4F EAGAN • `;r ,
Fee
Fil1 in numbered spaces 5/C
! Type or Print legibly Tot.
, ."
1. Date `%"'`+-C" 2. Insta
3. Job Addresi'F661
4. Owner
5. Contractor =` Y ??• "
?I ' Oi• 0 i
n Cost
;?
Blk. ' Tract ?? • i
?
.. iv • ??
?T? ,
Phone 825-68'6?
6. Address 4637 Ch].Gago _`ve.
7. City ;'??-"• State Zip 55407
8. Building Type: Residential ? Cammercial ? Institutional ?
9. Wark Description: New E] Add 0 Alter ? Repair ?
10. Describe- 3?+:-`_" 1- Fuel Type
Eauioment BTU - M. Ea. No. Equipment CFM
Forced Air
_ Air Handling:
Mfg.
- Boilers
Mech
Exhaust
Mfg. .
Unit Heater
Mfg. Other
Air Cond.
_ Mfg.
_ Gas, Piping Outlets
12. I hereby certify that the aboue informetion is true and correct, and I agree ta
comply with all ordinances and codes gaverning this #ype of work.
Signed : - for
Rough Final
Inspections: Date y Insp. Date (nsp.
This is your permit when num6ered and approved.
Approved CITY OF EAGAN 454-8100
(Irrfifirtttr af Orrixpttnry
of eaqan:. .. ?:.
` BPpttrtttcrni nf Builbing AspPd"wn ?
? _ ° , •^'.•?„?;,,-,y ° ..v _ ..-
Tbir Certifiratt iuurd puriunnt to tbe nqxirrnunu of Seitioa 306 of the Uniform BaiJding
Cade rMifying lhat at e/x time of ittaaxa tbit ttruttare ii+ar in romp&aruc witb tbt variour ?
ordinanas of tIx City nguTating bnilding ronrhartion os urr: 'Fo, tht folluudng:
- . ., ..? . . , t, . • ' ? a S.? ?'?'=. '-? - - -
u.a..?nm ". SF DWG/GAR ?;,,R?No' .. 6868 ^. -
O=w:rTrw R3 riwc?? v ?r L, NA ? u,u+a ?
o,.a,,w„, Josevh Miller ,,,,,m 13015 Cedar Aoe. So., AppL
: y:
D,,,: ' Sevtember 29. 1981
, ._ , -?.. .
-w u.ho,. u I.,
- CiTY OF EAGAN Np 6 8 6 g
" 7795 Pila! Knob Road Ggaa, MN 55121 -
PHONLt 454-8100
BUILDING PERMIT Receivt •# ?' ?7
T. L. ..A 6.. SF DWG/G9R c? v„I... $59t000 r?, September 10 1 y 81
sica n ?
ve
Lot Blnck Sec/Sub. ------ ---
Porcei # U_13500_ 200 04 1
w I Nome
Z
t Addre
SO
% Name OPneP
C
Addreu
oti..,. - - ----
Nome _
Addrea
I hereby acknowledga that I have reod this applicotion ond stata that
the inlormation is correct nrd ogree to comply with oll opplicable
Sfate of Mmnewta Stotures and City of Eayan Ordinances.
Sipnoturc of PermiMee
A Building Permit Is issued to: T^Ra
oll work shcll be done in xcordonce with oll
Erect XX Occuponcy R-3
Alrer p zoning R-1
Repoir ? Fire Zone NA
Enlarge ? Type of Const. 0
Move ? # Stories
Demolish ? Length44-
Grade ? Depth-45- Sq. Ft.-
Apyrorola Feas
Assessment _
Water 8 Sew.
Polite -
Fire
Enp.
Plonner _
Councll _
Bldg. Off. _
APC
Permit SlU.W
Surcharpe 29 -50
Plon check 155.00
snc 525.00
Water Conn. 335.00
WaterMeter 60•00
Road Unit 185.00
Total $1599.50.
on tM azpress wrdition ihat
y of Eo9an Ordinances.
Bulldirp Offlciol
This rlec{uest void F aCon {.? ?` ? ?aL q7 ? SO
?
18 months from a?SS a
Date of this Request '8-26-1981 Fire No. T4015"
I, as 9cLicensed Electrical Contractor OOwner, do hereby request inspection of the above electri-
cal wiring installed at:
Street Address or Route No. 4661 Cambridae City_
Section Township Range County DakotB
Which is occupied by Joe Miller Coaetruction
Is a roughin inspection required on this job? No ? Yes191 Ready Now ? Will Call lgc
Power Supplier _ Dakota Ctv Address FaSmin2ton
Electdcal Contractor O.B. Thompeon Electric Co.
(Company Name)
122011Mtka Hlvd.,
Mailing Address ,,,
Contractor's License NoA40602
Authorized Signature
(Electrical Contractof or Owner Making This Instal " lon)
?°???? ????? ???? This inspectian request will not be aceepted by the
c? State Board unless praper inspection fee is enclosed.
Mmnesota State tlOaW of EIeC[ncity
Griggs Midway Bidg. - Raom N191
AllialY.Wniversity Ave., $t. Paul, Minn. 55104 - Plwne 297•2111
REQUEST FOR ELECTRICAL INSPECTION
CHECK BELOlV WORKJCOVERED BY THIS REOUEST
EB-00001-02
-2CQS5-::?
T 40359
Type of Building New Add. Rep. Check Appliances Wired Eor Check Equlpment Wired Fm
Home EC ? ? Range 9X5•00 Temporary Wiring ?
Dupiex ? ? ? Water Heatei ? Lighting Futuies fiX
Apt. Bldg. ? ? ? Dryec ? Electric Heating ?
Commercial Bldg. El ? ? Fumace Silo Unloader ?
Industrial Bldg. ? ? ? Au Condilioner ? Bulk Milk Tank ?
Fatm ? ? ? Lisl S?co List
Other ? O ? Peie`s? DieD .D19h.? R?ers#
COMPUTE INSPECT[ON FEE BELOW
Seivice Entrance Size: # Fee Feeders&Sub(eedexs: # Fce Circuits: # Fce
0 to 100 Am sl Q jf , DU 0 to 30 Am eres 0 to 30 Am eres 2?0
]Oi to 200 Am s. 31 to 100 Am res 31 to 100 Am eres
Above 200 Amps. Above 100 Amps. Above 100 Am s.
Transfoimer Remote Control Circ. Partialorothecfee
S' S ecial Ins ec[ion Minimum fee
Rem
ROri CBp168
TOTALF L47.J?O
AS-OO
I, the%lectncal lnspector, hereby certify? the?'o? 'ns?pecti has be m?de
(Rough•in) (?c?• w Date
(Final) nA% Date
This request void
18 months from
w 8
I
?
?
?
.
i .
'oIl
Repue Date Fre No Rough-in Inapectlon R
sa' ? Re9tly Now ??or
W
,
Ye
G No hBn
Reetly
ID licensed contractor,66owner, hereby request inspection of above electrical work at:
Job ress ISVee1. Boe or o ta No ) Qty
/ //l
Section No Township Neme or No. Ranga No. Counry
Occu IPRINT,
? Phpne No.
I'l 0 J (
?
PowerSupplier Atltlrass
Eleclncal C nnactor ICOmDany l CoMradork License No.
o mEd cvn£r'
Mailing AtlEr 51Conhactor or Owner Making I nstellationl
?
AuIDOn ature IConhac Owner Mekmg I stelleLO 1 Phas NumbO
S ?T? O
?? p
/!'1 " w
MINNESOTR STATE BOARD OF ELECTPICITY THIS INSPECTION REQUEST WILL NOT
Grlpgs-Mldwey BIEg. - Room 5-173 BE ACCEPTEO BV THE STATE BOARD
1821 Ilniveraity Ave., St Peul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (812) 642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ?? ee-oaom-oe
? See mstmctions br complenng this Imm on beck ai yellow copy ?
L 3.9 8 5 2 Bel ow Work Covered by This Request
ew Mitl- REp TypeofBuiltling ApphencesWired EqmpmentWiretl ,
Home Range Temporary Service
Duplez Water Heater Electnc Heating
Apt. Building Dryer OfheNSpeafy)
Comm.llndustrial Furnace
Farm Air Conditioner
Otner (specM) Conhactor§ Remarks ?
Compute Inspechon Fee 8elow?
# Other Fee # ServiceEnirancaSize Fee # CirouMS/Feeders Fee
Swimming Pool 0 to 200 Amps a l0 100 Amps
Transformers Above 200 - Amps Ahove 100 _ Amps
Si9n5 Inspector5 Use Only ? 7? ?
Irngation Booms ?
Speaal Inspedion ,
Alarm/Commumcation THIS INSTALLATION MAY BE ORUEflE DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 78 M THS.
I, the Elechical Inspector, hereby
certify that the above inspection has
been made. Rouqn-nn
F,nai oace .
OFFICE USE ONLY
This request vmtl 18 monlhs irom '
8??u?,?;d ?
, ?dm; ,.tmn ?
A 079616 av ?
Nequest DatB Fire No_ Roiyh-in I?pec[ion
RepairN7
Will No4fY InSpec"
QI.aEy Now ?
? ? ? ? ? ?
pY¢s No xw Wh¢n Read
y
? Licemed Electrical Cwrtractar 1 hereby reqnest Imapac[ion oi above
14 Optaer eleetri?al wark i?ablbd at: I
Sveet AGdrzs, eoz or Ibute No. C.tr
ction TowmhiO Nan¢ p n Range o. Cwnty '
Occupant (P111M)
ON4-i--6 YN SGNL/9?E?2 Phone No.
`?S 41-ol 4'7B
Power SuPpliBr AUdRSs
Elecvicei Coimactd ICmVanY Name) Conaacxor's License Na.
SF4F?
Abilin0 Address (Con[rac[u or Owabr Yaking IreTailationl
Authariz/ Sipfatu^renICartOa?c?[w?{/Owner kinp Irebliatim) R?wurt?ber e?j
u?a N
L 1p
0
?
?YI r d I
/ S?
YINNFSOTA $Tp7E BppRD OF ELEG761CRY v THIS INSPECTION BEQUEST WILL NOT
Griqgs-Midwey Bldp. - Rowo N-787 fiE ACCEPTED 9Y THE STAIE BOARD
1821 UniwnityAve..Bt Paul. MN ?1W UNLE55 PROPER INSPECTION fE£ IS
' PM1One 1M 21297.2117 + `OSED. '
lt0(0 55 IEQUFST F08 a ION Ea.ooooi au .
th:, bm m Zack o, wl,o.
A QNGT-E :: "X"" Be/ow Mwk Cwereaf by This Hequest
Add Rep. Typeol6uiWino ApWearcesAirad Equ.?[8'i?
Hort1e Range Temporary Sercv+ce
Duplex Water Heater Liyhtiray Fixlures
< Apt Building Dryer Elecrtric Heatin
Crnm?ercial Bldg_ fumace SiJo Undoaie> '
Itrial Bldg. Air Caditioner 8ulk Miik Ta+nk
Fdfllt Other Other (Sper,, W> ?
Lnm, SpecifY O"er Othei
Compufe lnspection Fee Se/ow
M Fea Se,viceEM,anceSue A Fee Faaders/SUbfeaders % Fea Circuils
0 m200 Arnl? 0 to30A Dto 30
A6ova 200 31 to 700 Anps 39 to 100 ,q
Swimming Pool Above 100_ AHW5 Above 900_Amps
TramformerS Imi tion Booms Pzrtiai.'O
Sigts Special Inspec[ion TOTA
Re?rks
• ?
./l') A ? •
flou0h'in Oate ?e 1
? .
iieul ?? nsyecUan haa been
L` • mBde.
Sltla nquemvdd 78 mm?M fiom
CLAIM VOUCAER- REFUND REQUEST
CITY OF EAGAN
MAKE C'HECK PAYABLE TO: DONALD SCHLAFER
ADDRESS: 4661 CAMSRIDGE DR
EAGAN, MN 55122
PERMIT # 73329 Valuation: $4,000
RECEIPT #lDATE: 107776 5l16l2006
REASON FOR REFLIND: Owner decided not ro Uuild ga[age
TYPE OF REFUND:
Buildin Perxnit Base Fee 0801.4085 $ 97.25
Construction Meter De Refund 92202254 $
Club Box De osit Refund 9220.2253 $
Fire Su ression Pemut 0801.4096 $
Mechanical Penmit 0801.4088 $
Plan Review Fee 0720.4222 $
Plumbin Pemut 0801.4087 $
SAC (MGWS 9220.2275 $
SAC (Ci ) 9379.4681 $
SAC(Admm) 0801A246 $
Sewer Pernvt 6201.4532 $
Surcharge 90012195 $
TteatmentPlant 6101.4685 $
Water Pemut 6101.4507 $
Water Meters & Radio Read 6101.4509 $
Watei Su 1& Stoxa e 6101.4680 $
Other License Search Fee) 0201.4230 $
Total $ g7•25
I declare under the enal es of law that this account, claim, or demand is just and that no part of it has been paid.
07/06/2006
SI NATURE DATE
PatGeagan
MAVOR
Peggy Carlson
Cyndee Fields
Mike Maguire
Meg Tilley
COUNdL MENBENS
Thomas Hedges
(?.T' ADMINISTfiATOfl
MUNICIPAL CENTER
3630 Pilot Knob Road
Eagan, MN 55122-1810
651.675.5000 phone
651.675.5012 fax
651.454.8535 TDD
MMNTENANCE FACILRY
3501 Coachman Point
Eagan, MN 55122
651.675.5300 phone
651.675.5360fax
651.454.8535 TDD
www.cityofeagan.com
THE LONE OAKTREE
The sym6ol of
streng[h and growth
in our community.
7uly 6, 2006
MR DONALD SCHLAFER
4661 CAMBRIDGE DR
EAGAN MN 55122
RE: REFUND OF BUILDING PERMIT #73329
Deaz Mr. Schlafer:
As you requested, Building Permit #73329 issued on May 16, 2006 has been cancelled and a
refund of $97.25 will be forthcoming under separate cover. The State Surchazge of $2.00 has
been submitted to the State and is non-refundable.
If you have any questions, please feel free to give me a call at 651-675-5671.
Sincerely,
Janice D. Severson
Office Supervisor
cc: Dale Schoeppner, Chief Building Official
Donald Schlafer
4661 Cambridge Drive
Eagan, Mn. 55122
Jan Severson
City of Eagan
3830 Pilot Knob Road
Eagan, Mn. 55122
Regarding: Construction Permit Refund
Jan;
In May I applied for and received a 6uilding permit (no EA073329) from the City of Eagan
to add a 3ro stall to my existing garage located at 4661 Cambridge Drive. I have decided however,
I will not do the project this year and am inquiring about a possible refund of the permit fee of
$99.25. If this is possible please mail the refund to me at the above address.
If you have any questions you can contact me at work 651-687-2209 or home 651-454-
6978.
Thank you.
4,r el 44-0
DonaldSchlafer
?-----._
JUL - g
1
?
? gw.w
2006 RESIDENTIAI. BUII.DINC?i PERMIT APPLICATION
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone 4 651-675-5675 FAX # 651-6755694
New Construchon Reqmremenis
3 registered sde surveys showing sq ft. of Id, sq, fl of house; snd all roofed areas
(20% mazimum Iot coverege albwed)
2 copies of plan showing beam & window sizes; poured found design, etc.
1 set of Energy Calculafans
3 copies of Tree Preservahon Plan if lol planed afler 711/93
Rim Joist Detail Ophons selection sheet (buil6ngs with 3 or less units)
Minnegasco mechanicel ventilakion fonn
RemodeVReoair Reamremenls
2 copies of plan showing foo6ngs, beams, joisLs
1 set of Energy CalculaUons (or heated addtlions
1 site survey for additions & decks
Addition - udicate if orticite septic sysfem
4 qcA a5
D€fice. Use 4nfv
CETlv?SU?Y'RaGd . '.
- _.Y,._N
..
'fteePre§PI8[f:RCCC _Y: _N
tree ?Pres Required N
4asiteSeph6S0em _. ,..Y, ?tJ
-
Date 1:;_ I S l0 ?, Construction Cost ?:KYL>G 6
Site Address L/lP rk `j- C7 ll--k- UniU5te #
Description of Work A-Cl d ?r (?
Multi-Family Bldg _ Y X N Fireplace(s) _ 0 2
Property Owner Do n a( d -S C- Telephone #(?p5i )'-ts Y'- 64 7,S
Contractor
Address CiTy
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateeorv 1 Nfimiesota Rules 7672
Enefgy Code Category , Residential Ventilation Category 1 Worksheet ?Ilf ??p,?(,,?,? nergy Code Worksheet
(,I submisslon type) Submitted `°"[7"'?
• Energy Envelope Calculations Submitted MiQY O D
In the last 12 months, has The City of Eagan issued a permit for a similar plan based on a!A64la
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone #(
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a pernut, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
' !dA r! L-? ?G'?'L.'?'K-? ? ?=-C/? ?"? // ' ?-??Applicant's Printed Name Applicant's Signature /
DO NOT WRITE BELOW THIS LINE
IF .
Sub Tvpes
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01of_plex ? 09 07-plex x 17 Garage ? 22 PorchlAddn.(4-sea.) ? 33 Ext.Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvnes
O 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
X 32 AddRion ? 36 Move 8uilding ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building` ? 43 Reroof ? 46 Windows/Doors
? 34 ReplaCement 'Demolkion (Entire 81dg) - Give PCA handout to applicant
DESCfiptiOfl: Water Damage _ Yes
00
4
Valuation
0?/!? Occupancy ?-? MCES System
Plan Review /V
"dL 100% or_
25%
Census Code
Zoning ?
City Water
SAC Units - Stories Booster Pump "'-
# of Units ? Sq. Ft. 140 PRV '-
# of Bldgs ? Length ? Fire Sprinklered `
Type of Const _ YR Width /?-
REQUIRED INSPECTIONS
_ Footings(new bldg) Sheevock
Footings(deck) FinaUC.O.
? Foodngs(addiuon) ?- FinaUNo C.O.
Fommdation HVAC
_ Drain Tile _
Other
Roof _ Ice & Water Final Pool F[gs Air/Gas Tests Final
? Framing _ giding
Stucco Lath
Stone Lath Brick
_ Fireplace _ R.I. _ Air Test _ Final _
_
Windows
_ Insulation _ Retaining Wall
Approved By: , Building Inspector
Base Fee ? f-
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
?-yo/? r??Tn?k,ZA S??Afti C? /G`? 3Sk 4'0u
?
i
8K 55I23
, ;. . , . Certificate f'or:
Joe Miller Const.
13015 Cedar Ave, sa. DELMAR H. SCHWANZ
Apple valley, Mn• 55124 LANDSURVEVOR
Ragisterstl UnUar Lawl ot TheState o/ Minnesota
2978 - 746TN STREET W. - BOX M ROSEMOUNT, MINNESOTA 66088 PMONE 812 423-1769 O
?
9577 SURVEVOR'SCERTIFI;ATE •?D ?? ?
,,. P ?1v8
57. h 2 g4° 44?q ? E4.; 96o.ZD ? 84.Z8 ? P°1bo.7(o ?+ ?° W
_?r?--,---_?-
Ft._ i? 10
00
959. 30.1¢ ? w
1?g 61 ?
J
22 , Ld
a ?
W 47 ?
s 77° 00 2 a'
z 37" ? ? tiI ? 0 L'Q
0 3p C
. Seqle ? ? ?• 6??..= 6 1q9.?Z 1o ?L
hc? = 3O ¢-
e?T e?se%o8 ?
9? sq
0.-[ p,??? ?u H Gqe.iw,E F /
tOp Ciuea
6L.SO160.to QP- ?OOtES E.x%1'.Ti0G EI,tJM I oN EL-.'O)5¢A4
iNtSH wA?
p
?not se?od hub
Benchmark: op hydrant between lots and 26, Blk. 39
Elevation 963.45 ft.
I hereby certify that is is a true and correct representation of Lot 20,
Block 4, BEACON HILIS aceordLng to the recorde8 plat theraof, Dakota
County, Minnesota.
February 3, 1981
Revised to show proposed house as staked July 28, 1981
Ir,,-, 7
MINNESOTA REGISTRATION N0.88
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number.
Date Issued:
SITE ADDRESS:
P.I.N.: 10-13500-200-04
DESCRIPTION:
,
B&q'ild3"
Bui1d&n?
C',f3uiYding
Sui1cfing
r?
?. = r
?. , . .
'r:,, ?4{•? a
X 12' DECK
SF PORCW
NEW
16
10
???? ?? a-aga
REMARKS:
SEPARATE ELECTRICAL pERMIT REQUIRED
FEE SUMMARY:
4661 CAMBRID6E DR
LOT: 20 BLOCK: 4
BEACON HILL
aLso ie'
Permit 7ype
f3i?rk Type
L?Ryt? h
W?,dtfi
VALUATIQN $8,000
guxLozNG
021037
0&f27/93
Base Fee $99.00
Surcharge $4.00
Total Fee $193.80
CONTRACTOR:
OWNER: - ApPlicant -
SCHLAFER DONALD
4661 CAMBRIDGE DR
EAGAN MN
(612)454-6978
I hereby acknouledgs th8t i? r,satt tfa•i?
, infarmaticr.r? is carreat bnck 6g?ee 'Ck carir,p1j!
statutgg z,nd tity o'P •Eagan flrda,ecan4et. ,
L
?C C,? _
APPLICANT/PERMITEE SIGNATUR
APPI??a;t#?it ?:prd- ;?t?i??'2M
?X ai
a _. _? . . • ?_ ° ?
nr?n ?.?? I m?l
ISSUED Y: IGNATURE
KCNl.I1YNlC .
PERMIT # -
;
ZI?S7
tULuvED
LrMAI 11 1993
vi I I vr c.r?uru"
1993 BUILDING PERMIT
681-4675
APPLICATION
4n 3 "
SINGLE & MULTI-fAMILV 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural 8 structural plans, 1 set of
specifications, i copy of energy calcs.
Penalty applies: 1) when Permit is typed, but not picked up by last working day of month-
in which request is made, 2) address is changed or 3) lot change is requested once permit
is iSsued.
Date S /f-7/'I 2>_ Yaluation of work 1/7 S oa c)
Site Address: `r`Ga/ C'A-K BR1 .0 C .DR? V r
STREET SU1TE y
Tenant Name: (commercial only)
a ?
'WT BIAC& ? FSUBD. &,,
?.. ., ?t P.I.D. N '
Descri tion of work: 3 .SZ!_AsatJ f0P.cH $ t?40!?
The applicant is: 15 Owner ? Contractor ? OtI1B1' (De4eribe)
Name Scl7`??i=R ?PA-L-b . Phone .687'ZZa7 w
Property LAST FIRST -61?7e
Owner Address 4'xC61
STREET STE M
City State Zip Ss? 2 Z
Company F_ Phone
Contractor Address License # Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber . Processing time for
sewer 6 water,/Oermits is two days once area has been approved.
I hereby acknowledge that I have read this application and stat.e that the information is
correct and agree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant: ?'? ??'•
?
OFFICE USE ONLY
_r .. :
F{MIT TYPE
BUfLDtNG-PE . . ,
'
,
• ? S
?
, 4 .
.
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging 0 16 Basement Finish
;Sh02-4f-Xwg- O 07 4-Plex 0 12 Multi. Misc. El 17 Swim Pool
? 03 SF Addition O 08 8-Plex [3 13 Garage/Accessory ? 18 Comn./Ind.
(04 S?F -Ph ? 09 12-Plex ? 14 Fireplace ? 19 Comm./Ind. Misc.
O 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck ? 20 Public facility
? 21 Miscellaneous
woRK rrPe
O 31 New ? 33 Alterations ? 35 Tenant Finish ? 37 Demolish
? 32 Addition O 34 Repair ? 36 Move
GENERAL INF ORMATION
Const. (Actual) Y-N Basement sq. ft. MWCC System
A1lowable)
S v_N lst F1. sq. ft. City Water
ccupancy
UBC R2nd F1. sq. ft. PRV Required
Zoning Sq. Ft. Lotal Booster PumP
# of Stories Footprint Sq. ft. Fire Sprinkler
Length On-site well Census Code 43L/
Depth On-site sewage SAC Code
???5
APPROVALS ?
Planning Building Assessments
Engineering Yariance
RE('iUIRED INSPECTIONS ? Is o 16 'A/ 2' I)EZ)t-
'
? Site la Footing P? framing Z Insulation
O Wallboard a Final ? Draintile ? fireplace
Permi t Fee `19, O0 v.w.ci«m g?
Surcharge 114,00
Plan Review
License f?
MWCC SAC
Lity SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
li?, nh CLIS - s) -6 Lf vo
/ D dc::)
7(/o v
SAC %
SAC Units
10
The location of the improvements shown on this drawing are approximate and are based on a
visual inspection of the premises. The lot dimensions are taken from the recorded plat o
county records. This drawing is for informational purposes and should not be used as a
survey. It does not constitute a liability of the company and is intended for mortgage
purposes only.
EXHIBIT A
COMMITMENT COPIES TO: Northland Mortaaae CO - N
Ooldwell Bankex'
For Stewart Use Only:
PREV. PILE
I.EGAL CARD LY-0
NAME CARD ?J?
_ 1.'L/_a
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
? u 002,q 3830 PILOT KNOB RD - 55122
? 651-681-4875
? 3 rep4lered tlfe wneys thowhp p. R W bt, sq. R. ol house
and gU roOted areat <10X maxlmwn bf Covemae allowaAl
D 2 coples ol plau (fhow beam d whuiow sirss; pouretl fnd. dedgn; etcJ
D 1 59t Of 911619y COICWOHOf1E
y 3 coplw of hae pretervaNon picn H tol plaHed aRer 7/1/93
DATE: 3./ Z--!'J?? a
DESCRIPTION OF WORK:
STREET ADDRESS:
LOT: _IV) BLOCK: _q_ SUBD./P.I.D.6:
Name: sc h,LO;Ii, Phone t:
lasl Firat
?
'15b.Is
2 Oopies Ot plan
1 set a energr edcutana,: r« nearod addmons
1 aite wrvey (or extaftr adr8tlons & decks
cosr ? I 500. o ?
PROPERIY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Sheef
G r
.
i-u
r
cBy 47cc- srate: K, N zqr. !7'S 12 2
Companr Phone N:
(area code)
Sheet Address: Ucense # Exp.
Clly
Telephone Y: ( )
State: Z1P:
Name:
Sfreet Address: Regishallon A:
Clly
State:
Sewer/water licensed plumber (N Insfallina sewerlwaterl: Ptwne #:
Zip:
I herebY acknowtedge Mwt I have read lhis applicaNon, dale Ihaf Me Wortnafbn ia co . and agree fo comply wHh atl app8cable State
of Minnesota Statutea and CNy of Eagon Ordinances.
StflnaNre o( Applicont
OFFICE USE ONLY
Certiflcates of Survey Received _ Yes _ No
Tree Preservation Plan Received - Yes - No - Not Required
h? t
CITSt OF EAGAN
(Go`?BUIIDING PERMIT APPLICATION
7b Be Used For -New-Hmae-" Valuation
Site Pddress: y? ( , /
Incluc?e 2 sets of pians,
1 site plan w/elevations &
1 set of energy calculations.
Date
? OE'FICE USE 0l?II,Y
Lot 20 Block 4 Sec,/St?b, Beacon Hill
Parcel #: % O-?/?? So C? _ 2o_c?- ?j
Owner: Joseoh Miller Const. Inc.
Address: 1?i015 Cedar Ave. So.
City/Zip Code: Apple VAslle,y, MN 55124
Phone #: 454-4753
Contractor: same
Address:
City/Zip Code•
Pho? # : /
Arch./E,1zg. ?
Address: ?
City/ZiP Cocie:
Phone #:
Erect Occuparx,y
Alter Zoninq :x )
Repai r Fire Zorie J? V
Enlarge _ _
7Me of Const. V
Move # Staries
Dennlish
Grade Front ft.
De
th
f
p
y-
t.
APPI2O7AIS FEESS
Assessnents
Water/sewer ' Polioz
Fire?`
Eng•
Planner Council
Bldg. Off.
APC
Pettnit o 10
Surcharge q,
Plan Check ?
SAC
water Conn.
Water Meter
RDaa a,ut );Tg:PO
'117PAL 157 4 1 sd
,. BK 55/23
Zertlficate 2'or:
Joe Miller Conat. "
13015 Cedar Ave, so. DELMAR H. SCHWANZ
Apple Valley, IM. 55124 LqNDSUfiVEVOR
qpistantl UnCa Uws of TM StaN o} Minnetata
2978 - 146TH STREET W. -BOx M ROBEMOUNT, MINNESOTA 66066 ?MONE 672 4231789 Q
3?8?
SUR V EYOR'S CERTI FICATE
?
Ei.'957.T S g4o , T0P uve Toa Nwa o.i a"
s7. ? 44 t 4„F- EL : 9io ZO 184, t8 EL:% 960.710 ? w 1o a
?
--
00 .
?I ? y I W N
N0 , - .o-- I
y4171
lr? ^ I ? oi ?
V" ?QJ7
^ryj l? ( . ?r AQQ ?y4,
j Ll?
e
L ? ? C' '?o Q M ?ft. ?? ? (f
Ln
? Cx,,qr?? ? ? ? to-?acfl• ??n f? _ _ _? S ' ? ? ?
O CD
0
3l) ?+
?? L
Q
,p '
' 1? h C - 3 0 t
T
?
EL.rA4'Aa? ,y54'90
96o.'T p?„? ??u?sH Gaww?, fw? . (
6100 7oD Guee
??.-9?o.z.o D??,1oRes Ex.teiaa ??s?wr?oa Ea..-9gq..o4
Denot ssset?i+ood hub
Benchmark: Top hydrant between lots 25 and 26, Blk. 3,
Elevatlon 963.45 ft.
I hereby certify that thie is a trus and correct represonts;Uon of Lot 20,
'Block 40 BEACON HILIS, accordEng to the recorded plat thersvl, Dakota
County, Ntinneaota. E lk G PJ4
?
>
Feb7ruary 3, 1981
Revibed to show proposed houae as staked July 28,
f
lr z Z'. /
/ MINNESOTA REGISTfiAT10N NO.88
?
. .._. , . ;. . ,. • BK 55/23
.; Certificate f'or:
Joe Miller Const.
13015 Cedar Ave, so. DELMAR H. SCHWANZ
Apple VHlZBy, MTI• 55124 LANDSURVEVOR
Reqis[ersd UnOar Uws of TM SUta of MinnasoU
2978- 146TH STREET W. - 80X M ROSEMOUNT, MINNESOTA 56088 PHONE 812123-1769 O
?p ?
?;
?-9517 SURVEVOR'S CERTIFICATE
N
`?
o , „ ToP +?4e D.9D 1 ? a
957. ? s g4' 44 14 ? E?: 9W.TA ? 84.Z6 E? P°1b0. ? w ?o w'
-? '
-?` r/ ? - - _- - -
10 °?
? I.l,i
`;r ' ?-- ? 30.14 w
iOil"
A (1)
,Q49 °y? I L
5 ' Ld
?2 ? m (Ir
F,.. -e. ? LLI (0
95(P _?_ `, q?• ?. F 5 1 n
'roP Nad 0 30
r
, S C a I 2? 1'' hC &..' 955,oro ? 9g, 6Z ? ??o ?? L
3 (?e L µwe
rop
O ?r?? ?
+ fil E?:-R%00 Top {Roq
FeOposEo FmsN GaCAc.e Fwoe
top Gl?e.a
6t.•=O)w.2o 0eti.16TES Ex%4Ti0G E?.?uwt?oN EL..°9r7¢'.04
::5 zt`L A ne ot aseet?w oa nub 1N1{?H
Benchmark: Top hydrant between lots 25 and 26, Blk. 3,
Elevation 963.45 ft.
I hereby certify that this is a true and correct representat?lon of Lot 20,
Block 4, BEACON HILIS, aceordLng to the recorded plat thereof, Dakota
County, Minneaota.
February 3, 1981
Revised to show proposed house as ataked July 28, 1981
j ?
?-
,
MINNESOTA REGISTRATION NO.86
" OWIJER:
SITIi ADURE5S:
?
DATL 1111 ,9_
PIIONE:
COWTRIIC'1OR: M?G-?•JCI!!?
t;•_2i:?aiox rvvi:t.nPl: P.VI?fL1(:1: "u" OOMIIL'TATIUN
netezminc wozkinq square,footage of each
1. ToLa] exposed k•nl l irci. . . . . . sq. ft. x .ll _ _ _ ?d ? • 4 ? _
7 ?
2. Totil rouC/ueiling area ...... ? s9• ft. x .05
Total ex}:osed wall area above floar = 157
a. Total wall window area .................................
..,. ':_.r_i .??...>r nre.e .......................................
c. :JL?a2 sliuln;1 9:or.:: d:wr area .........................
d. Total firepIaae wali area .............................
o. ToC.il r+.ill franiny area (averagc 102) .... ... ........... 157.
.......•. 21
f. Total rim joist area .........................
g. _U .[_ wall. area above iloor ..........................
11. u r ..........................
1. Wtl - .......................•.. .
?• _??? . ...................
ToYal e>:pose3 foundation area L [O4. S
..-
k. ;•oinl Lo,u::iation windnw area ........................... ?
1. Tural met foundation area above grade .................
DoCcrmine "C" value of each wa)1 segment
(e.q. 4» ndcw, door, eaeh sepacate wall section)
a. x ?,utt .JlZ_
x „u„
a. ` x ----
---- •--. _ _ r 8 q
e. '' "U„
.,u„
x
x "u" ~
i . --- ---- - --
----- -------
.
?' - --- ------- x ?.u,. -------
l.. X 1%.
Tnb,l c
?? ?...
231, I
lL itcm N? is thc : c.mo a
?
dr'lcs_ Chan if.cm il, yu
Luvo mct tho intent nY
S11,^. G6Gf, (c) 2.
2004 RESIDENTIAL BUII.DING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWCtion Reouiremems RemodelfReoalr Reauiremems
3 ragistered site surveys showing aq. tt of b4 sq. ft of house; and J roofed areas 2 copfes of plan
(2096 macimum bt twerage alloured) 1 set of Eneigy Calatations fa healed additlons
2 wpies of plan showhg 6eam & window sims; poured fouM deslgn, etc. 1 stte survey for addltions 8 dedcs
1 set of Eneigy Cakuletions Addition -ind(cete d on-slte septic system
3 wptes o(Tree Preservatbn Plan if lot pqCed afler 711193
Run Joiat Detail Op6ons selection sheet (bldgs wtUi 3 w kss unb
Datc -7_ / 15 / oy Construction Cost -? S o 0 '
Site Address Cr¢rvt. /4A / 0 GL ?vt v'/= Un te #
vl /Q S " 2- Z
Description o[ Work fZ ? S clj?"A?
Muld-Family Bldg _ Y _ Fireplace(s) 2
Propetty Owner Telephone # ((Q S r)
contractor 5,f!?z G. F
Address City
State 7r'p ? one? )
x` \
COMPLETE T7esc REA ONLY IF CONSTRUCTING
Energy Code Category h ul es 7670 Cau? 1 _
(J submission lype) Residential Ventilation Category 1 Worksheet
SubmiCed
. Energy Envelope CalculaUons Submitted
Have you previously constructed a building in Eagan with a similar plan?
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
?
A NEW BUILDING
Minnesota Rules 7672
• New Energy Code Worksheet
Submttted
Y_ N If so, 25% plan review
Telephone #(
I hereby apply for a Residential Building Permit and aclmWwledge that?i'ie`infor4ation is complete and accurate;
that the work will be in conformance with the ordinance " es-e- - of Eagan and the State of MN
Statutes; I understand this is not a pernut, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
Applicant's Printed Name
?
Applicant's Signature
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